Managing Program Change: Experience From Maximizing Enrollment States in Leadership, Culture Change, Coordination, and Data

Since 2009, eight states participating in the Robert Wood Johnson Foundation’s Maximizing Enrollment program have worked to streamline eligibility and enrollment systems, policies, and procedures. Through the course of the program, state teams pursued programmatic change both to realize their own visions for coverage, and to respond to environmental shifts including a recession, elections, and the enactment of the Affordable Care Act. This Maximizing Enrollment report examines how grantee states wove key strategies together into a tapestry of change management: (1) providing leadership to achieve culture change; (2) improving data analysis to target and track policy changes; and (3) focusing on coordination across the various state and local entities administer eligibility systems.